Lie of the year: Government takeover' tramples facts for a political punchline

View full sizeThe Associated PressSigns like this one, at an August 2009 rally in downtown Atlanta, crystallized the objections of many opponents to the health care reform legislation supported by President Barack Obama and Congressional Democrats.

By Bill Adair and Angie Drobnic Holan

The claim that the Democratic health care law is a "government takeover of health care" is our 2010 Lie of the Year.

In the spring of 2009, a Republican strategist settled on a brilliant and powerful attack line for President Barack Obama's ambitious plan to overhaul America's health insurance system. Frank Luntz, a consultant famous for his phraseology, urged GOP leaders to call it a "government takeover."

"Takeovers are like coups," Luntz wrote in a 28-page memo. "They both lead to dictators and a loss of freedom."

The line stuck. By the time the health care bill was headed toward passage in early 2010, Obama and congressional Democrats had sanded down their program, dropping the "public option" concept that was derided as too much government intrusion. The law passed in March, with new regulations, but no government-run plan.

But as Republicans smelled serious opportunity in the midterm elections, they didn't let facts get in the way of a great punchline. And few in the media challenged their frequent assertion that under Obama, the government was going to take over the health care industry.

PolitiFact editors and reporters have chosen "government takeover of health care" as the 2010 Lie of the Year. Uttered by dozens of politicians and pundits, it played an important role in shaping public opinion about the health care plan and was a significant factor in the Democrats' shellacking in the November elections.

By selecting "government takeover" as Lie of the Year, PolitiFact, the St. Petersburg Times' independent fact-checking website, is not making a judgment on whether the health care law is good policy.

The phrase is simply not true.

Said Jonathan Oberlander, a professor of health policy at the University of North Carolina at Chapel Hill: "The label 'government takeover' has no basis in reality but instead reflects a political dynamic where conservatives label any increase in government authority in health care as a 'takeover.'"

"Government takeover" conjures a European approach where the government owns the hospitals and the doctors are public employees. But the law Congress passed, parts of which have gone into effect, relies largely on the free market:

-- Employers will continue to provide health insurance to the majority of Americans through private insurance companies.

--Contrary to the claim, more people will get private health coverage. The law sets up "exchanges" where private insurers will compete to provide coverage to people who don't have it.

-- The government will not seize control of hospitals or nationalize doctors.

-- The law does not include the public option, a government-run insurance plan that would have competed with private insurers.

-- The law gives tax credits to people who have difficulty affording insurance, so they can buy their coverage from private providers on the exchange. But here, too, the approach relies on a free market with regulations, not socialized medicine.

PolitiFact reporters have studied the 906-page bill and interviewed independent health care experts. We have concluded it is inaccurate to call the plan a government takeover because it relies largely on the existing system of health coverage provided by employers.

It's true that the law does significantly increase government regulation of health insurers. But it is, at its heart, a system that relies on private companies and the free market.

Republicans who maintain the Democratic plan is a government takeover say that characterization is justified because the plan increases federal regulation and will require Americans to buy health insurance.

But while those provisions are real, the majority of Americans will continue to get coverage from private insurers. And it will bring new business for the insurance industry: People who don't currently have coverage will get it, for the most part, from private insurance companies.

Consider some analogies about strict government regulation. The Federal Aviation Administration imposes detailed rules on airlines. State laws require drivers to have car insurance. Regulators tell electric utilities what they can charge. Yet that heavy regulation is not described as a government takeover.

This year, PolitiFact analyzed five claims of a "government takeover of health care." Three were rated Pants on Fire, two were rated False.

PolitiFact sought to count how often the phrase was used in 2010 but found an accurate tally was unfeasible because it had been repeated so frequently in so many places. It was used hundreds of times during the debate over the bill and then revived during the fall campaign. A few numbers:

--The phrase appears more than 90 times on website, the website of House Speaker-designate John Boehner of Ohio, GOPLeader.gov.

-- It was mentioned eight times in the 48-page Republican campaign platform "A Pledge to America" as part of their plan to "repeal and replace the government takeover of health care."

-- The Republican National Committee's website mentions a government takeover of health care more than 200 times.

Conservative groups and tea party organizations joined the chorus. It was used by FreedomWorks, the Heritage Foundation and the Cato Institute.

The phrase proliferated in the media even after Democrats dropped the public option. In 2010 alone, "government takeover" was mentioned 28 times in The Washington Post, 77 times in Politico and 79 times on CNN. A review of TV transcripts showed "government takeover" was primarily used as a catchy sound bite, not for discussions of policy details.

In most transcripts we examined, Republican leaders used the phrase without being challenged by interviewers. For example, during Boehner's Jan. 31 appearance on "Meet the Press," Boehner said it five times. But not once was he challenged about it. In rare cases when the point was questioned, the GOP leader would recite various regulations found in the bill and insist that they constituted a takeover. But such follow-ups were rare.

Politicians and officials in the health care industry have been warning about a "government takeover" for decades.

The phrase became widely used in the early 1990s when President Bill Clinton was trying to pass health care legislation. Then, as today, Democrats tried to debunk the popular refrain.

When Obama proposed his health plan in the spring of 2009, Luntz, a Republican strategist famous for his research on effective phrases, met with focus groups to determine which messages would work best for the Republicans. He did not respond to calls and e-mails from PolitiFact asking him to discuss the phrase.

Democrats tried to combat the barrage of charges about a government takeover. The White House and House Speaker Nancy Pelosi repeatedly put out statements, but they were drowned out by a disciplined GOP that used the phrase over and over.

Rep. Earl Blumenauer, D-Ore., whose provision for Medicare end-of-life care was distorted into the charge of "death panels" (last year's Lie of the Year), said the Republicans' success with the phrase was a matter of repetition.

"There was a uniformity of Republican messaging that was disconnected from facts," Blumenauer said. "The sheer discipline ... was breathtaking."